Treatments and drugs

Anorgasmia can be difficult to treat. Your treatment plan will depend on the underlying cause of your symptoms, but your doctor may recommend a combination of lifestyle changes, therapy and medication.

Lifestyle changes and therapy

For most women, a key part of treatment includes addressing relationship issues and everyday stressors. Understanding your body and trying different types of sexual stimulation also can help.

Understand your body better. Understanding your own anatomy and how you like to be touched can lead to better sexual satisfaction. If you need a refresher course on your genital anatomy, ask your doctor for a diagram or get out a mirror and look. Then take some time to explore your own body. Self-stimulation or using a vibrator can help you discover what type of touch feels best to you, and then you can share that information with your partner. If you're uncomfortable with self-exploration, try exploring your body with your partner.

Increase sexual stimulation. Women who've never had an orgasm may not be getting enough effective sexual stimulation. Most women need direct or indirect stimulation of the clitoris in order to orgasm, but not all women realize this.

Switching sexual positions can produce more clitoral stimulation during vaginal penetration; some positions also allow for you or your partner to gently touch your clitoris during sex. Using a vibrator during sex also can help trigger an orgasm. Mental imagery or fantasizing during sex also may help.

For some women, a device called a clitoral vacuum may improve blood flow and increase stimulation. This device is battery operated and hand-held, with a cup that fits over the clitoris.

Seek couples counseling. Conflicts and disagreements in your relationship can affect your ability to orgasm. A counselor can help you work through disagreements and tensions and get your sex life back on track.

Cognitive behavioral therapy. This type of therapy attempts to change the negative thoughts you may have about sex. You may be given directed masturbation exercises to do at home to learn how to achieve orgasm on your own.

Try sex therapy. Sex therapists are therapists who specialize in treating sexual concerns. You may be embarrassed or nervous about seeing a sex therapist, but sex therapists can be very helpful in treating anorgasmia. Therapy often includes sex education, help with communication skills, and behavioral exercises that you and your partner try at home.

For example, you and your partner may be asked to practice "sensate focus" exercises, a specific set of body-touching exercises that teach you how to touch and pleasure your partner without focusing on orgasm. Or you and your partner may learn how to combine a situation in which you reach orgasm — such as clitoral stimulation — with a situation in which you desire to reach orgasm, such as vaginal penetration. By using these techniques and others, you may learn to view orgasm as one pleasurable part of sexual intimacy, not the whole goal of every sexual encounter.

Medical treatments

Hormone therapies aren't a guaranteed fix for anorgasmia. But they can help. So can treating underlying medical conditions.

Treating underlying conditions. If a medical condition is hindering your ability to orgasm, treating the underlying cause may resolve your problem. Changing or modifying medications known to inhibit orgasm also may eliminate your symptoms.

Estrogen therapy for postmenopausal women. Systemic estrogen therapy — by pill, patch or gel — can have a positive effect on brain function and mood factors that affect sexual response. Local estrogen therapy — in the form of a vaginal cream or a slow-releasing suppository or ring that you place in your vagina — can increase blood flow to the vagina and help improve sexual arousal. In some cases, your doctor may prescribe a combination of estrogen and progesterone.

Testosterone therapy. Testosterone plays an important role in female sexual function, though in much lower amounts. As a result, testosterone may help increase sexual arousal. However, replacing testosterone in women is controversial and it's not approved by the Food and Drug Administration for sexual dysfunction in women.

Additionally, it can cause negative side effects, including acne, excess body hair (hirsutism) and male-pattern baldness. Testosterone seems most effective for women with low testosterone levels as a result of surgical removal of the ovaries (oophorectomy). If you choose to use this therapy, your doctor will closely monitor your symptoms to make sure you're not experiencing negative side effects.

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